摘要
目的 探讨分别在耳内镜下和显微镜下手术治疗中耳胆脂瘤的临床效果。方法 回顾性选取2017年1月—2022年7月于江苏省苏州眼耳鼻喉科医院收治的64例中耳胆脂瘤患者的临床资料,根据手术时间和方式的不同,将患者分为耳内镜组和显微镜组。耳内镜组在2020年3—7月完成的中耳胆脂瘤手术,共30例;显微镜组在2017年1月—2020年2月完成的中耳胆脂瘤手术,共34例。比较两组术后远期听力恢复效果、干耳时间、并发症和复发情况。结果 两组患者术后的听力情况均较术前改善,且耳内镜组的术后听力情况优于显微镜组,差异有统计学意义(P<0.05)。耳内镜组干耳时间为(4.05±0.24)周,短于显微镜组的(7.01±0.32)周,差异有统计学意义(t=41.407,P<0.05)。两组的并发症如面瘫、脑脊液耳漏、感染发生情况进行比较,差异无统计学意义(P>0.05)。随访1年后,两组患者复发率比较,差异无统计学意义(P>0.05)。结论 耳内镜下和显微镜下手术治疗中耳胆脂瘤效果均明显,二者术后并发症发生率和复发率相似,但耳内镜下中耳胆脂瘤手术改善患者听力效果更为明显,干耳时间更短,手术更微创,临床中耳内镜下结合显微镜辅助的中耳胆脂瘤手术更为稳妥。
Objective To explore the clinical effects of surgical treatment of cholesteatoma of middle ear under otos-copy and microscopy,respectively.Methods The clinical data of 64 patients with middle ear cholesteatoma admitted to the Suzhou Eye,Ear,Nose and Throat Hospital,Jiangsu Province from January 2017 to July 2022 were retrospec-tively selected as the study objects.According to the different operation time and methods,the patients were divided into the otoscopy group and the microscope group.In the otoscopy group,a total of 30 cases of middle ear cholestea-toma surgery were completed from March to July 2020.A total of 34 cases of middle ear cholesteatoma surgery were completed in the microscope group from January 2017 to February 2020.Long-term hearing recovery,dry ear time,complications and recurrence were compared between the two groups.Results The postoperative hearing of patients in both groups was better than that before surgery,and the postoperative hearing of patients in the otoendoscope group was better than that in the microscope group,and the difference was statistically significant(P<0.05).The dry ear time in the endoscopic group was(4.05±0.24)weeks,which was shorter than that in the microscope group(7.01±0.32)weeks,and the difference was statistically significant(t=41.407,P<0.05).There was no significant difference in the in-cidence of complications such as facial palsy,cerebrospinal fluid otorrhea and infection between the two groups(P>0.05).After 1 year of follow-up,there was no significant difference in recurrence rate between the two groups(P>0.05).Conclusion Both endoscopic surgery and microscopic surgery have obvious effects in the treatment of middle ear cholesteatoma,with similar postoperative complication rates and recurrence rates.However,endoscopic surgery for middle ear cholesteatoma has more obvious hearing improvement effects,shorter ear drying time,and more minimally invasive surgery.Clinical middle ear endoscopic surgery combined with microscopy-assisted middle ear cholestea-toma surgery is more secure.
作者
孙祥
SUN Xiang(Department of Otolaryngology,Suzhou Eye,Ear,Nose and Throat Hospital,Suzhou,Jiangsu Province,215006 China)
出处
《中外医疗》
2023年第33期26-30,共5页
China & Foreign Medical Treatment
关键词
耳内镜
显微镜
中耳胆脂瘤
微创
听力
复发
Otoscopy
Microscope
Cholesteatoma of middle ear
Minimally invasive
Hearing
Recurrence
